High rates of depression have been reported in patients with neurological disorder, endocrinologic/metabolic disorder, post- myocardial infarction, malignancy, and chronic obstructive pulmonary disease. Studies have documented a clear excess of cardiovascular disorders among older compared with younger depressed patients. Rates of persistent depressive disorder in middle-aged and elderly persons following myocardial infarction have been especially high. Despite numerous studies in the population of patients with coronary artery disease (CAD) and post myocardial infarction, few studies have focused specifically on the prevalence of depression other psychiatric problems and its prognostic effects in patients with chronic heart failure (CHF). CHF is a major public health problem in the United States. Currently, it is estimated by the National Heart, Lung, and Blood Institute that over 3 million Americans suffer from CHF, and about 400,000 new cases are diagnosed each year. A large number of factors have been found to correlate with mortality in patents with CHF. Clinically, the presence of CAD as the etiology of CHF, an audible S3, low pulse and systolic blood pressure, a high NYHA functional class (greater than 11), and reduced exercise capacity have been shown to be associated with increased risk of death. There is evidence which suggests that the rate of depression may be high in the CHF population, maybe even higher than the rate in CAD patients. With the evidence of higher mortality and morbidity which occur in CAD patients with depression, it is speculated that CHF patients with depression bear higher mortality and morbidity as well. Provided that depression is modifiable and therefore results in a better outcome, studies to learn the prevalence of depression and its association with prognosis in the CHF population are promptly needed and, if the results are similar to what is observed in the CAD population, trials to evaluate therapeutic interventions will be undertaken consequently.